Document text
Principal Investigator: DAVID S HONG
Organization: MAINSQUARE CO
Fiscal Year: 2024
Award: $424,754
Funding agency: National Institute of Mental Health
Abstract – MainSquare Co. (dba “Teleo”) is developing a HIPAA-compliant virtual therapy room for children that
transforms how clinicians deliver psychotherapy to children remotely, improving client engagement over standard
video conferencing platforms (e.g., Zoom). One in 5 children have a mental health disorder. Remote teletherapy
can help by enabling more accessible, convenient, and lower-cost care for children. Given these advantages,
mental healthcare providers are permanently adopting telehealth. As of September 2022, 88% of mental health
treatment providers offered Telehealth, versus 39% in April 2019. Unfortunately, clinicians working with children
remotely experience low in-session engagement. Today, 50-70% of children end treatment early due to low
engagement and the median number of sessions attended is one. Low engagement is tied to worse clinical
outcomes in children and reduced revenue for health systems due to no-shows, treatment drop-out, and therapist
distress / provider turnover. In-session engagement – active involvement in an intervention – is associated with
improved outcomes for depression, anxiety, and substance disorders
Teleo improves client engagement by 1) integrating evidence-based therapy tools, worksheets, activities, and
games – from Teleo or providers – into a single virtual space with video conferencing, eliminating platform
switching and streamlining use of evidence-based practices (EBPs); 2) making interventions more interactive
through new two-way mirroring technology, eliminating screen and link sharing, and making previously one-sided
activities highly collaborative; and 3) making virtual environments personalizable to each client. Teleo is in pilot-
use by dozens of early-adopting clinicians. Of these, 83% say Teleo improves engagement with clients; 42%
say Teleo improves clinical outcomes; 88% would be disappointed without Teleo. Teleo is in pilot with the largest
community mental health provider to youth Medicaid populations in CA and cleared IT / compliance a large
community health system (6,000+ child psych patients / month). Teleo has commercial interest from 40 other
organizations. This STTR funds otherwise impossible empirical validation called upon by early partners.
In Phase I, Teleo will conduct user experience focus groups and interviews to solicit qualitative feedback from
both clinicians and patients. Based on feedback, the product will be iterated upon and then utilized in a pilot
randomized control trial (RCT) with 42 subjects over 4 sessions to evaluate the potential for Teleo to improve
pediatric patient engagement in teletherapy relative to standard video conferencing. In Phase II, Teleo will
perform R&D to improve clinician acceptability, clinical workflows, and client engagement. Again, the product will
be evaluated in an RCT but this time vastly expanded to include 156 subjects over 12 sessions with broad patient
diversity. Engagement and clinical outcomes, as well as practice performance and value-based outcomes, will
measured in Teleo and compared to standard-of-care. The resulting empirical evidence will substantiate whether
Teleo enhances pediatric behavioral health, promoting trust, credibility, and adoption in the commercial market.
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